#I'm just intensely weird lads medical history has been a lifelong interest of mine

[burninglights]

Industrial Revolution & Pharmacopoeia Boom Time! Many thanks for enabling me, and putting up with my ramblings about nonsense areas of specialty.

NB: I am a biomedical science undergrad, not a medical historian. I've been reading books and academic texts from a young age and consequently retained a worrying amount of weirdly niche medico-historical knowledge. My particular areas of knowledge are the history of cancer therapeutics and the history of pharmacology (and battlefield medicine in Renaissance Europe, but that's beside the point). I'll link reputable sources in case you want to do some Actual Academic Reading of your own; please double check dates if you're planning to reference this post, especially for the government reforms.

First, some context. Medicine in the 1800s was dragged kicking and screaming into the predecessor of modern medicine, mostly by necessity. The development of the steam engine meant the rapid growth of industry thanks to automation that allowed for a much higher product output, and the railways that transported the workers to man said machines into centres of industry and cities.

Unfortunately, with mass movement of people comes disease, especially when the infrastructure for public housing and sanitation just doesn't exist.

With a few exceptions, most notably the philanthropic worker's housing programmes of Rowntree, Robinson, and Cadbury (yes, those ones), most factory workers not only worked incredibly dangerous and gruelling jobs but lived in crowded tenement buildings. These were ideal conditions for the spread of communicable diseases like TB, dysentery, cholera and typhus, all of which ran rife at one point or another.

The thing about communicable disease is that it's a universal affliction, and with the wealthy also susceptible to TB & cholera and the general unpleasantness of dumping all of your sewage directly into the Thames - something that lead to the Great Stink of 1854 - it was time for the government to begrudgingly wave goodbye to the policy of laissez-faire and actually start affecting sociopolitical change.

Cities forced preventative measures - the 1832 inquiry into the Poor Laws, the 1834 New Poor Laws, the Public Health Act of 1848, and the bigger, better 1875 Public Health Act - and leaps and bounds in the medical sciences (the birth of public epidemiology with John Snow and the 1854 cholera outbreak and Pasteur's confirmation of bacteria as the cause of disease in 1850 with germ theory) provided the first steps towards significant combative measures.

The boring bit is over! You came here for the drugs, and the drugs you shall get (metaphorically, of course).

Major leaps and bounds were being made in the chemical sciences too, especially when it came to isolating the active compounds of drugs and understanding how drugs affect people (mostly by medical professionals and the scientifically curious doing So Many Substances in doses and combinations that by all rights should have killed them, but the point stands).

Morphine was isolated in 1803, heroin trotting along not too far behind, and the invention of the hypodermic needle in 1840 made administering opiate drugs a damn sight more convenient. James Simpson proved that chloroform and ether were effective anaesthetic agents in humans in 1840.

(It is at this point I must shout out my boys James Lister, the pioneer of aseptic surgery and Ignaz Semmelweiss, who pioneered handwashing to combat childbed fever in Hungary and who was absolutely done dirty by his peers.

Their work is not strictly relevant to the pharmacopoeia boom, but they're the reason we have surgery that won't kill you dead of sepsis. Their work was, and is, incredibly vital to medicine.)

The reason you see all of those Jesus Christ That's Literally Just Potion of Insta-Death bottles of Victorian medicine is because fairly often, pharmacists with access to these isolated active agents would combine them with other drugs known to be effective in treating certain symptoms and patent them as cover-all medicines.

The medicalisation of addiction, understanding of addiction pathways and understanding of multi-drug intoxication didn't come along until later.

Sadly, overdose, especially in the case of children, wasn't all that uncommon.

You'll notice I said that treatment was primarily of symptoms, not of diseases.

Germ theory was still in its infancy at this point, and without the knowledge that specific microbes means specific disease, meaning specific treatments, the pharmacological M.O. was 'throw everything you've got at it and hope Something works'.

The Colonial Dick Measuring Contest that constituted Europe from around 1850 through to the beginning of World War One was a period known as the second Industrial Revolution, and also when synthetic chemistry, the idea that specific microorganisms = specific disease and the use of synthetic chemistry in pharmacology really kicked off in earnest.

The Bayer company of Germany became a pharmacological powerhouse, much to the disdain of the French (because their nations had beef, Pasteur & Erhlich spent their later years embroiled in a scientific pissing contest, which is incredibly funny but mostly irrelevant to this aside from the development of my favourite historical drug Salvarsan 606) and the British.

Side note: the Bayer company also refined methamphetamine drugs in the Weimar period in Germany, leading to the development of Previtin — the drug from that Finnish soldier post — that was given to the troops of the Third Reich. Norman Ohler's Blitzed is a really interesting account of drug development in Germany with the context of the world wars, if that's of any interest to you.

Anyway!

While the military arms race to build as many Dreadnought class warships as possible so that you'd have a bigger metaphorical dick than your neighbour loomed ominously in the sociopolitical background, a different, smaller kind of arms race was going on; the war against illness (with a side helping of German and French nationalism). A better understanding of medical chemistry meant that new pharmacological ground was being broken regularly; paracetamol was first made in 1877, Felix Hoffman, who worked for the Bayer company, modified salicylic acid to create acetylsalicylic acid (aspirin to you & me) in 1897.

The development of specific microbiological/vital staining techniques like Gram staining (yay!), trypsin blue stain (yay!) and Ziehl–Neelsen staining (absolutely yay - it was used to identify Mycobacterium tuberculosis, the bacteria responsible for TB) solidified the idea that specific pathogens = specific illness, which was incredibly helpful for drug development.

Arsphenamine, also known as Salvarsan 606 (my beloved!!!! this drug was the first synthetic chemotherapeutic agent and it's so fucking cool) was introduced at the beginning of the 1910s as the first effective treatment for syphilis. This ushered in the age of the sulfonamide antimicrobial drugs to treat infectious disease.

All of these new wonder drugs would be put to use - when available, which all too often they weren't - for casualties of war in 1914, when the assassination of Archduke Franz Ferdinand ushered in a global conflict on a scale nobody could have imagined; the Great War, or WWI.

So yeah! that's a (not so) brief run down of the Big Drug Boom of the Industrial Revolution.

Thanks for tolerating me and I'm sorry for obliterating your dash. Double thanks and all of my love to @ronniebox, @hellolovelyscientist, @tsuyu-season, @yarnings, @starsong-dragonheart and @swords-n-spindles for being magnificently patient and enthusiastic and putting up with my nonsense.

#the history of medicine #medical science #medical history #world history #history of pharmacology #pharmacology #science #again I reiterate: please check dates & cross reference especially for the parliamentary acts #I'm a hobbyist not a professional #I'm just intensely weird lads medical history has been a lifelong interest of mine #and I was allowed to read medical literature from age 7 #in retrospect it should have been apparent a lot sooner to a lot more people that all was not neurotypical with me #long post #em.txt #adventures in biomed #now edited for grammar and spelling